Background
Surgical masks (SMs) are used to reduce bacterial shedding from the mouth, nose and face. This study aimed to investigate whether SMs may be a potential source of bacterial shedding leading to an increased risk of surgical site infection.Methods
Bacterial contamination of the SMs was tested by making an impression of the external surface of the mask on sterile culture media immediately. We investigated the difference in bacterial counts between the SMs worn by surgeons and those placed unused in the operating room (OR), and the bacterial count variation with indicated wearing time. Moreover, the difference in bacterial counts on the external surface between the first and second layers of double-layered SMs was also assessed.Results
The bacterial count on the surface of SMs increased with extended operating times; significant difference was found between the 4- to 6-hour and 0-hour groups (p < 0.05). When we analysed the bacterial counts from the same surgeon, a significant increase was noted in the 2-hours group. Moreover, the bacterial counts were significantly higher among the surgeons than the OR. Additionally, the bacterial count of the external surface of the second mask was significantly higher than that of the first one.
Conclusions
The source of bacterial contamination in SMs was the body surface of the surgeons rather than the OR environment. Moreover, we recommend that surgeons should change the mask after each operation, especially those beyond 2 hours. Double-layered SMs or those with excellent filtration function may also be a better alternative. The translational potential of this article This study provides strong evidence for the identification that SMs as source of bacterial contamination during operative procedures, which should be a cause for alarm and attention in the prevention of surgical site infection in clinical practice.
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Abstract
Introduction: Healthcare personnel are at high risk for exposure to influenza by direct and indirect contact, droplets and aerosols, and by aerosol generating procedures. Information on air and surface influenza contamination is needed to assist in developing guidance for proper prevention and control strategies. To understand the vulnerabilities of healthcare personnel, we measured influenza in the breathing zone of healthcare personnel, in air and on surfaces within a healthcare setting, and on filtering facepiece respirators worn by healthcare personnel when conducting patient care.
Methods: Thirty participants were recruited from an adult emergency department during the 2015 influenza season. Participants wore personal bioaerosol samplers for six hours of their work shift, submitted used filtering facepiece respirators and medical masks and completed questionnaires to assess frequency and types of interactions with potentially infected patients. Room air samples were collected using bioaerosol samplers, and surface swabs were collected from high-contact surfaces within the adult emergency department. Personal and room bioaerosol samples, surface swabs, and filtering facepiece respirators were analyzed for influenza A by polymerase chain reaction.
Methods: Thirty participants were recruited from an adult emergency department during the 2015 influenza season. Participants wore personal bioaerosol samplers for six hours of their work shift, submitted used filtering facepiece respirators and medical masks and completed questionnaires to assess frequency and types of interactions with potentially infected patients. Room air samples were collected using bioaerosol samplers, and surface swabs were collected from high-contact surfaces within the adult emergency department. Personal and room bioaerosol samples, surface swabs, and filtering facepiece respirators were analyzed for influenza A by polymerase chain reaction.
Conclusions: Healthcare personnel may encounter increased concentrations of influenza virus when in close proximity to patients. Occupations that require contact with patients are at an increased risk for influenza exposure, which may occur throughout the influenza season. Filtering facepiece respirators may become contaminated with influenza when used during patient care.
Results
Exercising at 3 MET while breathing through N95-mask materials reduced mean tidal volume (TV) by 23.0 % (95 % CI −33.5 % to −10.5 %, p < 0.001) and lowered minute ventilation (VE) by 25.8 % (95 % CI −34.2 % to −15.8 %, p < 0.001), with no significant change in breathing frequency compared to breathing ambient air. Volumes of oxygen consumption (VO2) and carbon dioxide expired (VCO2) were also significantly reduced; VO2 by 13.8 % (95 % CI −24.2 % to −3 %, p = 0.013) and VCO2 by 17.7 %, (95 % CI −28.1 % to −8.6 %, p = 0.001). Although no changes in the inspired oxygen and carbon dioxide concentrations were demonstrated, breathing through N95-mask materials during low intensity work (3 MET) reduced expired oxygen concentration by 3.2 % (95 % CI: −4.1 % to −2.2 %, p < 0.001), and increased expired carbon dioxide by 8.9 % (95 % CI: 6.9 % to 13.1 %; p <0.001) suggesting an increase in metabolism. There were however no changes in the maternal and fetal heart rates, finger-tip capillary lactate levels and oxygen saturation and rating of perceived exertion at the work intensity investigated.
Conclusions
Breathing through N95 mask materials have been shown to impede gaseous exchange and impose an additional workload on the metabolic system of pregnant healthcare workers, and this needs to be taken into consideration in guidelines for respirator use. The benefits of using N95 mask to prevent serious emerging infectious diseases should be weighed against potential respiratory consequences associated with extended N95 respirator usage.
https://aricjournal.biomedcentral.com/articles/10.1186/s13756-015-0086-z
Results: Distance was not modified by the mask (P=0.99). Dyspnea variation was significantly higher with surgical mask (+5.6 vs. +4.6; P<0.001) and the difference was clinically relevant. No difference was found for the variation of other parameters.
Conclusion: Wearing a surgical mask modifies significantly and clinically dyspnea without influencing walked distance.
The new coronavirus is real.
The response to the coronavirus is hyped. And in time, this hype will be revealed as politically hoaxed.
In fact, COVID-19 will go down as one of the political world’s biggest, most shamefully overblown, overhyped, overly and irrationally inflated and outright deceptively flawed responses to a health matter in American history, one that was carried largely on the lips of medical professionals who have no business running a national economy or government.
https://www.washingtontimes.com/news/2020/apr/28/coronavirus-hype-biggest-political-hoax-in-history/
A frontline nurse working in New York on coronavirus patients claims the city is killing sufferers by putting them on ventilators, advocating against them
The nurse persuaded a friend, a nurse practitioner who is not working on coronavirus patients, to make the video to get the word out
‘It’s a horror movie. Not because of the disease, but the way it is being handled,’ the frontline nurse said through the friend, who only was identified as Sara NP
Sara said COVID-19 patients are placed on ventilators rather than less invasive CPAP or BiPAP machines due to fears about the virus spreading
She explained: ‘The ventilators have high pressure, which then causes barotrauma, it causes trauma to the lungs’
More than 12,000 people have died from the virus in NYC, with another 4,300 dying in other parts of the Empire State
New York emergency room doctor Cameron Kyle-Sidell stepped down this month because he didn’t want to follow the hospital’s ventilator protocol
Republican Minnesota Senator Scott Jensen told Fox News’ Laura Ingraham that Medicare pays hospitals three times as much if patients are placed on ventilators
Scientists who advised the World Health Organization on its influenza policies and recommendations—including the decision to proclaim the so-called swine flu a “pandemic” had close ties to companies that manufacture vaccines and antiviral medicines like Tamiflu, a fact that WHO did not publicly disclose.
Council of Europe to discuss whether pharmaceutical firms spread alarm over pandemic to boost orders of medicines
European health chiefs are to hold emergency talks about whether pharmaceutical giants have unduly influenced governments into squandering public money on vast stockpiles of unnecessary swine flu drugs.
At today’s hearing, several committee members pressed the WHO and vaccine company officials on two main issues. They expressed deep suspicions that vaccine industry experts on WHO advisory groups improperly influenced the WHO’s assessment of the pandemic in order to financially benefit pharmaceutical companies. Council members also questioned the WHO official, Dr Keiji Fukuda, special advisor on pandemic influenza to the WHO director-general, about confusion surrounding consideration of severity in its definition of a pandemic, which was revised at about the time the novel H1N1 virus was identified.
Some government public health officials and influenza experts have strongly rejected Wodarg’s claims, defending vaccine stockpiling as a prudent public health response and calling the charges “preposterous.”
In his opening statement, Wodarg said he was skeptical about the threat of the H5N1 virus and the contracts that countries had in place with vaccine makers in the event of a pandemic. “WHO had the trigger,” he said, alluding to the pandemic plans of some countries that activate the contracts when the WHO declares the highest alert level. He speculated that vaccine makers are making a financial windfall from what he claims are more expensive patented and adjuvanted vaccines. He also argued that the billions that governments have spent on pandemic vaccines could be better spent on other health issues.
He charged that the change in pandemic definition “made it possible to turn a run-of-the-mill flu into a pandemic and translate into millions for vaccine for no good reason.”
Wodarg also claimed that adjuvanted vaccines used in Europe were not adequately tested, especially in children, and expressed doubts about the safety of cell-based pandemic vaccines.
- Britain is losing £2.4 billion per day during the lockdown.
- All the savings during the austerity period have been squandered.
- A ‘capital levy’ or confiscation of private property may be on the horizon.
Results: Thirty nine patients (23 men; mean age, 57.2 years) were recruited for participation in the study. Seventy percent of the patients showed a reduction in partial pressure of oxygen (PaO2), and 19% developed various degrees of hypoxemia. Wearing an N95 mask significantly reduced the PaO2 level (101.7 +/- 12.6 to 92.7 +/- 15.8 mm Hg, p = 0.006), increased the respiratory rate (16.8 +/- 2.8 to 18.8 +/- 2.7/min, p < 0.001), and increased the occurrence of chest discomfort (3 to 11 patients, p = 0.014) and respiratory distress (1 to 17 patients, p < 0.001). Baseline PaO2 level was the only significant predictor of the magnitude of PaO2 reduction (p < 0.001).
Conclusion: Wearing an N95 mask for 4 hours during HD significantly reduced PaO2 and increased respiratory adverse effects in ESRD patients.
The 48-year-old physician, father of two and aspiring triathlete worried that an invasive ventilator would be harmful. But soon after entering the clinic, Bergmann said, he struggled to breathe even with an oxygen mask, and felt so sick the ventilator seemed inevitable.
Even so, his doctors never put him on a machine that would breathe for him. A week later, he was well enough to go home.
Bergmann’s case illustrates a shift on the front lines of the COVID-19 pandemic, as doctors rethink when and how to use mechanical ventilators to treat severe sufferers of the disease – and in some cases whether to use them at all. While initially doctors packed intensive care units with intubated patients, now many are exploring other options.
It is a common laboratory practice to propagate viruses in cell culture. While convenient, these methodologies often result in unintentional genetic alterations, which have led to adaptation and even attenuation in animal models of disease. An example is the attenuation of hantaviruses (family: Bunyaviridae, genus: Hantavirus) when cultured in vitro. In this case, viruses propagated in the natural reservoir species cause disease in nonhuman primates that closely mimics the human disease, but passaging in cell culture attenuates these viruses to the extent that do not cause any measurable disease in nonhuman primates. As efforts to develop animal models progress, it will be important to take into account the influences that culture in vitro may have on the virulence of viruses. In this review we discuss this phenomenon in the context of past and recent examples in the published literature.
One next step should be making the lockdown voluntary, not mandatory. People can be asked — not ordered — to be careful. To keep their distance, not take undue risks. Return to work, where it’s safe to do so. Send young children back to school. Sweden has tried this approach and found a strong public response. Travel to Easter holiday hotspots was down 94 per cent; city streets, even now, are almost deserted. Sweden’s logic is that economic repair can happen more quickly if the pandemic is controlled by public consensus, with liberties protected.
https://www.spectator.co.uk/article/the-case-for-trusting-the-public-is-stronger-than-ever
When foreign commentators discuss Sweden’s light-touch response to Covid-19, they tend to adopt an affronted tone. Which is, on the surface, surprising. You’d think everyone would be willing the Nordic country to succeed. After all, if Sweden can come through the epidemic without leaving a smoking crater where its economy used to be, there is hope for the rest of the world. So far, many signs appear encouraging. The disease seems to be following the same basic trajectory in Sweden as elsewhere.
https://www.telegraph.co.uk/news/2020/04/25/sweden-succeeds-lockdownswill-have-nothing/
During the Cold War, the British Government used the general public as unwitting biological and chemical warfare guinea pigs on a much greater scale than previously thought, according to new historical research.
In more than 750 secret operations, hundreds of thousands of ordinary Britons were subjected to ‘mock’ biological and chemical warfare attacks launched from aircraft, ships and road vehicles.
Up until now historians had thought that such operations had been much less extensive. The new research, carried out by Ulf Schmidt, Professor of Modern History at the University of Kent, has revealed that British military aircraft dropped thousands of kilos of a chemical of ‘largely unknown toxic potential’ on British civilian populations in and around Salisbury in Wiltshire, Cardington in Bedfordshire and Norwich in Norfolk.
We included three trials, involving a total of 2106 participants. There was no statistically significant difference in infection rates between the masked and unmasked group in any of the trials. We identified no new trials for this latest update.
From the limited results it is unclear whether the wearing of surgical face masks by members of the surgical team has any impact on surgical wound infection rates for patients undergoing clean surgery.
https://www.cochranelibrary.com/cdsr/doi/10.1002/14651858.CD002929.pub3/full
A new analysis by Edge Health, a leading provider of data to NHS trusts, warns that a second and then a third wave of “non-corona” deaths are about to hit Britain. Unless radical solutions can be found to resume normal service and slash waiting lists, the NHS may be forced to institute a formal regime of rationing.
Over long periods of time, social isolation can increase the risk of a variety of health problems, including heart disease, depression, dementia, and even death. A 2015 meta-analysis of the scientific literature by Julianne Holt-Lunstad, a research psychologist at Brigham Young University, and colleagues determined that chronic social isolation increases the risk of mortality by 29%.
https://www.sciencemag.org/news/2020/03/we-are-social-species-how-will-social-distancing-affect-us